How many mental health professionals has the VA hired to meet the needs of veterans returning from Iraq and Afghanistan as well as Vietnam veterans? The VA says the answer is maybe 6,000. The number of psychologists in FY 2006 probably had increased to about the same number that the VA had in FY 1995. As of the beginning of FY 2012, the VA had approximately 3,300 psychologists. We still do not know how many psychiatrists they have, how many clinical social workers, or how many psychiatric nurse practitioners are on board. Nor how they are distributed.

Despite the efforts of the VA Secretary, the bureaucracy remains a barely navigable maze. Measures to ensure transparency and accountability must be part of the funding of the VA. Congress must ask where funds are going and how they are to be spent. It’s difficult for the VA to argue that there is not waste in its myriad operations and programs.

In short, we need oversight hearings that are effective in determining where the added billions of taxpayer dollars are going at the VA, particularly in regard to PTSD and mental health in general. VA clinicians from all over America, when asked why they are not following the best medical science for diagnosing and assessing PTSD, answer that the problem is a lack of resources.

We do not know how many clinicians the VA needs. However, we do know that the VA is ignoring the recommendations from the three multimillion dollar studies done by the Institute of Medicine of the National Academies of Science which the VA itself commissioned and paid for.

We need better bipartisan oversight to ensure wiser spending of resources by the VA. The morning prior to the VVA Conference of State Council Presidents meetings with their Members of Congress, the Secretary of the Department of Veterans Affairs announced in a press bulletin that he had ordered the hiring of 1,900 new mental health professionals for the VA as directed by Congress – clearly in anticipation of our Hill meetings.

Of the approximately 23 million veterans alive today, some 8 million are registered with the VA healthcare system, although only about 6 million actively utilize VA healthcare services. Yet many of those who use the VA often are ignorant of the benefits to which they are entitled and their service-related health conditions and health care risks.

Because the VA has never had a reputation for effective outreach to veterans, VVA established the Veterans Health Council. The core mission of the VHC is to inform and educate the private-sector health care community – as well as veterans and their families – about veterans’ benefits and health issues.

To their credit, under Secretary Shinseki the VA has started to use TV and radio advertising and social media to advertise and promote VA services. But the VA needs to do a much better job of taking military histories for every veteran and educating VA clinicians about the health risks that veterans have been exposed to. The VA does not need more money to do this; rather, it needs to use its resources more wisely.

EXPANDING CAREGIVER COVERAGE

Almost two years ago, Congress passed Public Law 111-163, the Caregivers and Veterans Omnibus Health Services Act, to great acclaim. The new law empowered the VA Secretary to develop regulations to provide compensation and assistance for family caregivers of troops grievously injured or wounded in the fighting in Afghanistan and Iraq. One subsection reads: “the Secretary shall submit a report on the feasibility and advisability of expanding the provision of assistance to family caregivers of veterans who have a serious injury incurred or aggravated in the line of duty in the active military, naval, or air service before September 11, 2001.” His report is due this month.

MILITARY SEXUAL TRAUMA

The VA needs to provide and evaluate gender-specific, intensive sexual treatment residential programs, with an emphasis on meeting the needs of the increasing number of homeless veterans who have experienced military sexual trauma and are without resources to travel to VA facilities. Congress should work with the Undersecretary for Benefits to establish a method to identify and track claims related to military sexual trauma to determine the rate at which such claims are awarded or denied and the rating awarded for the various diagnoses.

PREDATORY FOR-PROFIT INSTITUTIONS OF HIGHER LEARNING

The Post-9/11 GI Bill has been a godsend for men and women who have served in uniform. It has also been an opportunity for certain for-profit colleges to rip off – albeit legally – the system. They often spend $10,000-$20,000 to hook veterans and active-duty troops, National Guard, and Reservists who qualify to enroll in their schools, and then spend only $700 a semester on educating them. Veteran students are more than disappointed when they find out that the credit hours they worked for are not transferrable to most state colleges, or the degree they’ve earned isn’t worth the paper it’s printed on.

Legislation has been introduced in the Senate by Sens. Patty Murray (D-Wash.) and Jim Webb (D-Va.), who introduced the original GI Bill legislation, and in the House by Rep. Gus Bilirakis (R-Fla.), among others, to rectify this betrayal of trust that has already cost American taxpayers hundreds of millions of dollars.

VVA also advocates for the expansion of the VET-Success program, in which colleges and universities have full-time veteran-staff who help veteran-students deal with problems at home and issues at school. It’s one thing to enroll veterans in school; it’s quite another to help them negotiate the pressures of their lives and stick with the program long enough to graduate and get good jobs.

VETERAN-OWNED SMALL BUSINESS

The VA is required by law to maintain a database of service-disabled, veteran-owned small businesses and veteran-owned small businesses. Congress imposed a requirement for a reasonable certification or verification that those listed are, in fact, owned and controlled by veterans or service-disabled veterans. Unfortunately, the VA’s Center for Verification and Evaluation has turned this operation into a real mess, constantly losing evidence in support of applications, and taking too long to make often arbitrary or just plain wrong decisions not to verify a business. The result of this bureaucratic ineptitude has cost hundreds of veteran-owned businesses millions of dollars – and has put some out of business altogether.

VVA, along with VET-Force, the Veterans Entrepreneurship Task Force, and other veterans’ service organizations, will continue to work toward a just and proper verification process that actually helps legitimate veteran-owned, small business owners.

PROTECTING THE PROGENY OF VETERANS

The VA’s Research & Development program seems to have forgotten about Agent Orange: Not a dime, it appears, goes for research into the effects of the dioxin, and very little into the effects of toxic substances in general. VVA is particularly concerned about our children and grandchildren. We keep hearing the stories of children who grew up with a variety of birth defects, major health issues, and learning disabilities, and whose children have many of the same maladies, when previously there had been no family history of any of these ills.

The one factor that might account for these health conditions was a parent’s exposure to Agent Orange. There is a lot of scientific evidence that points to a positive association. We also wonder if veterans of subsequent wars and conflicts are having similar issues.

POW/MIAs

As it has been for more than thirty years, the highest national priority of VVA is to continue to make meaningful progress toward the goal of achieving the fullest possible accounting of our nation’s POW/MIAs. To that end, it is imperative that the President and the Secretary of Defense continue to drive this issue and that Congress continues to provide the necessary resources in support of the Defense Prisoner of War Missing Personnel Office and for the recovery and identification operations conducted by the Joint POW/MIA Accounting Command.

VVA’s 2012 Legislative Agenda is a product of the Government Affairs Committee, chaired by Ric Davidge, and the Government Affairs staff.